Ahsan Zahab S, Song Yohan, Yao Jeffrey
Indiana University School of Medicine, Indianapolis, IN, USA.
J Hand Surg Am. 2013 Aug;38(8):1520-3. doi: 10.1016/j.jhsa.2013.04.040. Epub 2013 Jul 3.
To evaluate the outcomes of patients with ulnar impaction syndrome treated with a jig-facilitated, oblique, diaphyseal ulnar shortening osteotomy and fixed with a TriMed (Santa Clarita, CA) ulnar osteotomy compression plate.
A retrospective chart review of patients with ulnar impaction syndrome identified 38 patients who had had ulnar shortening osteotomy and fixation with the TriMed dynamic compression system. The following clinical data were obtained: patient age, sex, follow-up range of motion, grip strength, and complications. After a minimum of 2 years after surgery, patients reported complications and completed a Disabilities of the Arm, Shoulder, and Hand questionnaire.
Eight patients were lost to follow-up. Compared to the opposite limb at an average of 8 months after surgery, the remaining 30 patients attained 92% to 97% of wrist and forearm motion and 71% of grip strength. The average Disabilities of the Arm, Shoulder, and Hand score was 12 after a minimum of 2 years after surgery. Four patients required plate removal due to irritation. Two patients reported persistent ulnar-sided pain, and 2 other patients developed atrophic nonunions and required autologous bone grafting. There were no infections.
Ulnar shortening osteotomy using the TriMed system yielded good clinical outcomes that are comparable to those previously documented using other systems.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
评估采用定位导向斜形尺骨干缩短截骨术并使用TriMed（加利福尼亚州圣克拉丽塔）尺骨截骨加压钢板固定治疗尺骨撞击综合征患者的疗效。
对尺骨撞击综合征患者进行回顾性病历审查，确定38例行尺骨缩短截骨术并用TriMed动力加压系统固定的患者。获取以下临床数据：患者年龄、性别、随访时的活动范围、握力及并发症情况。术后至少2年，患者报告并发症并完成手臂、肩部和手部功能障碍问卷。
8例患者失访。与术后平均8个月时对侧肢体相比，其余30例患者的腕部和前臂活动度达到了92%至97%，握力达到了71%。术后至少2年时，手臂、肩部和手部功能障碍平均评分为12分。4例患者因刺激需要取出钢板。2例患者报告尺侧持续疼痛，另外2例患者出现萎缩性骨不连并需要自体骨移植。无感染发生。
使用TriMed系统进行尺骨缩短截骨术可产生良好的临床疗效，与先前使用其他系统记录的疗效相当。
研究类型/证据水平：治疗性IV级。
